Astellas' clostridium antibiotic Dificlir cut recurrence, costs

Real-world data on Astellas’ Dificlir has shown that the narrow-spectrum antibiotic significantly reduces recurrence and all-cause mortality when used first-line in all patients with Clostridium difficile infection.

Data from the CDI Service Evaluation study shows that, compared to traditional broad-spectrum antibiotics, first-line use of targeted therapy Dificlir (fidaxomicin) in all CDI patients improved outcomes compared to use in selected patients only.

The study looked at over 1,450 patient episodes across seven hospitals in England that introduced Dificlir between July 2012 and July 2013, and then compared the data with a retrospective cohort treated with broad-spectrum antibiotics vancomycin and metronidazole during the prior 12 months.

Two of these centres - A and B - used Dificlir as first-line treatment for all patients while the other five only used it as first-line treatment in selected patients for both primary and recurrent CDI. Data collected on 177 patient episodes treated first-line with Astellas’ drug showed a significant reduction in 28-day all-cause mortality, from 18.2% to 3.1% and 17.3% to 6.3% respectively.

The analysis also showed dramatically reduced recurrence rates: from 12.1% and 23.5% in centres A and B with standard of care treatments (vancomycin and metronidazole), to 3.1% in both these centres where Dificlir was used first-line, the firm said.

On the cost side, adopting Dificlir as a first-line therapy for all patients generated savings of £19,490 at centre A, based on five recurrences avoided for every 50 patients, and £121,144 at the second site, based on 10 recurrences avoided per 50 patients .

Last year Astellas published findings of another real-world study carried out at St George's Hospital in London, England, also showing that Dificlir led to a reduction in recurrence of CDI and a saving of more than £48,000 versus treatment with vancomycin or metronidazole.